title: [The radiosurgery of glioblastoma multiforme in cases of recurrence. The Heidelberg experiences compared to the literature].
abstract: OBJECTIVE
  To describe the clinical results a prospective phase II study of radiosurgically treated patients with recurrent glioblastoma multiforme.
  
  
  METHODS
  Since 1986, 62 patients were irradiated stereotactically. Including criteria were residual tumor < or = 5 cm and Karnofsky performance score > or = 70. Twenty-seven patients (mean age 50 years) were treated for recurrent tumor. The planning target volume was defined by the contrast enhancing region demonstrated by magnetic resonance imaging (MRI) scans which were performed in treatment position. A safety margin of 2 to 5 mm was added. The mean dose was 17 Gy. The median interval from the time of initial diagnosis and therapy to radiosurgery for recurrent tumor was 9.6 months. Initial therapy consisted of surgery and irradiation (60 Gy). Survival curves were calculated according to the Kaplan Meier method. Quality of life was evaluated using objective criteria such as neurological findings, frequency of seizures and steroid medication.
  
  
  RESULTS
  The median survival calculated from the time of diagnosis was 18 months, calculated from the time of radiosurgery 9 months. 4.5 months after therapy, 50% of the patients showed improved or stable quality of life.
  
  
  CONCLUSIONS
  Radiosurgery demonstrates efficacy in selected patients suffering from recurrent glioblastoma multiforme.
authors.affiliation: Klinische Radiologie, Schwerpunkt Strahlentherapie, Universität Heidelberg.
authors.forename: M
authors.initials: M
authors.lastname: van Kampen
authors.forename: R
authors.initials: R
authors.lastname: Engenhart-Cabillic
authors.forename: J
authors.initials: J
authors.lastname: Debus
authors.forename: M
authors.initials: M
authors.lastname: Fuss
authors.forename: B
authors.initials: B
authors.lastname: Rhein
authors.forename: M
authors.initials: M
authors.lastname: Wannenmacher
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000601:surgery*; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D005909:Glioblastoma / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D011446:Prospective Studies; D016634:Radiosurgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D011879:Radiotherapy Dosage; D013997:Time Factors
vernacular_title: Radiochirurgie des Glioblastoma multiforme in der Rezidivsituation. Heidelberger Erfahrungen im Literaturvergleich.